Notes on the cholera at Varna in 1854 : and more especially in Her Majesty's Ship Agamemnon, in the Black Sea, between the 1st August 1854 and 8th September 1855 / by George Mackay.
- Mackay, George.
- Date:
- 1857
Licence: Public Domain Mark
Credit: Notes on the cholera at Varna in 1854 : and more especially in Her Majesty's Ship Agamemnon, in the Black Sea, between the 1st August 1854 and 8th September 1855 / by George Mackay. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![These may be said to be the last cases of an epidemic character which appeared in the fleet; and, as they were comparatively few, and I have already alluded to the case which occurred at this time on board the Agamemnon, I will now conclude these Notes with a few words on the treatment. A few words must indeed suffice, as we unfortunately found, to our sad disappointment, that, in almost all the first cases of each separate outbreak, the disease was quite intractable, and proceeded to its fatal termination, more or less rapidly, according to the intensity of the exciting cause, and irrespective of all remedial measures. As, however, among several remedies exhibited, one or other may, in the estimation of the anxious observer, appear to claim a preference, I am inclined to attribute more beneficial effects to the administration of calomel than to any other medicine. I believe that the rapid exhibition of calomel, in scruple, ten grain, five grain, or two grain doses, either alone, or combined with opiates, will occa- sionally arrest the downward progress of the disease; but its imme- diate use must be had recourse to, if we would hope to have any power over the complaint. Conjointly with its exhibition must be the assiduous and persevering use of frictions of the whole body, but more especially of the parts attacked by spasm; and these frictions are best performed by the hands of tliree or four men, messmates of the patient, who are to be relieved by others in the same manner and time (two or four hours) as if taking their regular watch on deck. I have seen much and grateful relief afforded to the patient by constant frictions from the hands of muscular men. They ought to be continued, not only to the relief of spasm, but until some de- gree of heat (if possi])le) be restored to the surface. To allay the irritabiUty of stomach, and thereby assist the action of medicine, sinapisms are to be applied to the epigastrium, and draughts of chloroform, gsther, opium, hydrocyanic acid, etc., are to be administered. To allay thirst, and yet to avoid the vomiting sure to follow large draughts of water, or other drinks, it is necessary to administer fre- quently small quantities (from a tablespoonful to a wine-glassful) of water tinctured with brandy; and the time of its administration may be made subservient to, or coincident with, the exhibition of the calomel. As local stimulants, sinapisms to the lower extremities, and tur- pentine epithems to the abdomen, were found to be of some benefit in our cases; and we also had recourse, in some cases, to an enema (though not in the exact doses), as suggested and practised by Dr Jamieson, then attached as staif-surgeon to the British Military Hospital at Varna, of half-a-drachm to a drachm of quinine, in brandy §i. and starch ; or the same quantity of quinine in brandy, and beef-tea in place of arrow-root. We tried this enema, and re-](https://iiif.wellcomecollection.org/image/b22274510_0042.jp2/full/800%2C/0/default.jpg)
